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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cervical cancer screening by visual inspection in Cte d'Ivoire, operational and clinical aspects according to HIV status
BMC Public Health, Volume 12, No. 1, Article 237, Year 2012
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Description
Background: Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed. Methods. A cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART) in Abidjan, Cte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model. Results. The frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0) in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1) in the 1,047 HIV-negative ones (p < 10 -4). In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23)] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08)]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (p < 10 -4). Conclusion. The higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure. © 2012 Horo et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Horo, Apollinaire Gninlgninrin
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Jaquet, Antoine
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Ékouévi, Didier Koumavi
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Cote D'ivoire, Abidjan
Aconda
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Toure, B.
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Coffié, Patrick Ahuatchi
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Cote D'ivoire, Abidjan
Aconda
Effi, Ahoua Benjamin
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Messou, Eugéne
Cote D'ivoire, Abidjan
Aconda
Minga, Albert Kla
Cote D'ivoire, Abidjan
Centre Médical de Suivi de Donneurs de Sang/cnts/primo-ci
Moh, Raoul D.
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Koné, Mamourou
Cote D'ivoire, Abidjan
Centre Hospitalier Universitaire de Treichville
Dabis, Franćois Ç.Ois
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Sasco, Annie Jeanne
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Statistics
Citations: 67
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1186/1471-2458-12-237
e-ISSN:
14712458
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Multi-countries
Participants Gender
Female